Résultats de la neurostimulation tibiale postérieure transcutanée pour hyperactivité vésicale chez les patients diabétiques [Outcomes of transcutaneous posterior tibial nerve stimulation for overactive bladder in diabetic patients]
Résumé
Objective Treatment with transcutaneous posterior tibial neurostimulation (NTPT) has been shown to be effective in the treatment of overactive bladder (OAB), but its outcomes in diabetic patients have never been assessed. The aim of this study was to compare the efficacy of NTPT in diabetic OAB patients and in OAB patients without diabetes. Methods A single-center prospective study included all patients treated with NTPT for lower urinary tract storage symptoms between 2012 and 2016. The primary endpoint was symptoms improvement ≥ 50% assessed using a Visual Analog Scale (VAS) two months after starting NTPT. Treatment consisted in a daily 20-minute NTPT single-session. The secondary endpoints were lower urinary tract symptoms reported by bladder diary, the Urinary Symptom Profile, the impact on mood and on daily activities. Results Seventy-one patients were included, 10 of whom were diabetic. The efficacy rate (EVA > 50%) was not significantly different in the diabetic group (70% vs. 44.1%, P = 0.17), like the mean EVA efficacy was similar in both groups (4/10 vs. 4/10, P = 0.98). OAB USP sub-score diminished significantly in both groups at 2 months (−3 points in the diabetic group; −1.9 points in the non-diabetic group; P = 0.03 and P < 0.0001, respectively). There was no significant difference between the groups, except for the rate of patients who stopped treatment at 6 months, higher in diabetic patients (100% vs. 63.5%, P = 0.04). Conclusion The functional outcomes of NTPT appear to be similar in the treatment of OAB in diabetic patients and in non-diabetic patients. Level of evidence 4. © 2017 Elsevier Masson SAS